Internet to Sex: Defining Addiction

Addiction is used to describe everything from the Internet to shopping to sex. So how do you tell when something really becomes an addiction?

By Dulce ZamoraWebMD Feature

Reviewed By Brunilda Nazario

Fifteen-year-old Lily has finally found Kevin, the man of her dreams, on the Internet. He has a gift of knowing what to say to make her feel good, despite the disappointments she's had with a broken family and a recent move to a new city with her mom.

So she spends hours chatting with her online companion, alienating herself from family and friends. Soon after a face-to-face meeting with the 20-something-year-old, she gives in to his aggressive sexual demands and contracts chlamydia, a sexually transmitted disease. When Lily's friends try to intervene in the relationship, Kevin becomes angry and tries to kill one of them.

Sound too far-fetched to be true? Maybe. Maybe not. While this is a current storyline on The Young and the Restless, a daily soap opera on CBS, there are viewers who can attest that elements of the plot are a bit too realistic for comfort, according to Jack Smith, executive producer and co-head writer of the daytime drama.

He says many parents have responded to the fictional situation, writing letters about their own concerns and experiences of their children's extensive use of the Web. According to him, they say things like, "You're telling our story."

Dangerous Online Habit

The possibility that kids will meet sketchy people online during their extended use of the Net surely strikes deep into the fears of parents. Smith himself has a 14-year-old daughter who has dozens of virtual buddies, a number of them strangers. It was his worries about the number of hours she was logged on that inspired the cyber abuse tale.

Although he says he does not regard his daughter as an Internet addict like the character Lily and he does not think that she has had a risky online encounter, the Y&R exec still finds disturbing the idea that people could take on anonymous personalities on the Web and not be held accountable for their actions.

"The Internet could be a real environment for predators," says Smith. His remarks mirror the words of some mental health professionals who say that particular features of the Web not only promote compulsive behavior, but danger, too.

David Greenfield, PhD, a clinical psychologist in Connecticut, says other characteristics of the Net encouraging addiction include easy access, sense of timelessness, the hypnotic quality of the screen, and the unfinished, intermittent nature of information.

What's even worse, he says, is the "synergistic effect" that these characteristics have when combined with stimulating Web content that, in themselves, could be habit-forming. Such content could be found in gambling, shopping, stock trading, video gaming, and porn sites, and cybersex chat rooms.

For instance, "You may have a predilection for liking pornography," explains Greenfield, "but when the pornography is in your face, is easily accessible, affordable, and is available at any time and any place in an anonymous way, that lowers the threshold in regard to acting out with that behavior."

Greenfield, who has authored a book called Virtual Addiction, is one of several mental health experts that recognize Internet addiction as a growing problem, certainly one that could facilitate other compulsions. He says that 6%-10% of online users are addicted to the Web, and about half of them visit porn sites or have cybersex chats.

His estimations appear similar to the figures used by the Illinois Institute for Addiction Recovery, which put the number of addicted Internet users at 5%-10% of those online.

The institute has compiled the findings of various studies on addictions and has determined the following: Of the general population, 8%-10% are addicted to alcohol or chemicals, 1.5%-3% to gambling, 1%-3% to food, 5% to sex, and 2%-8% to spending.

There are specialists, however, who question the legitimacy of the use of the word "addiction" in relation to various topics. The term, critics say, may now be used too loosely.

Defining Addiction

Conservative radio talk show host Rush Limbaugh recently confessed to his listeners that he was addicted to painkillers. Actress Halle Berry's estranged husband, Eric Benet, reportedly checked himself into a rehabilitation center last year for treatment of a sex addiction.

There's certainly nothing new about addictions among celebrities and common folk, but the type of compulsive behavior reported appears to be more varied. It seems people used to talk only of alcohol or drug addiction. Now, the discussion also involves things such as food, sex, shopping, gambling, and the Internet.

The American Society of Addiction Medicine (ASAM) describes addiction as a compulsive behavior with a continued craving to use a psychoactive substance.

Although ASAM neither favors nor opposes treatment for other problems, the organization's president, Lawrence Brown, MD, MPH, does believe that the term addiction is often misused.

"Most people know someone who they think is an 'addict,'" he says. "What they mean by that, if you ask 10 people, you may likely get 10 different answers -- even among my esteemed colleagues."

Brown says his group is only concerned about matters that are scientifically proven to be a great public health concern. He notes the overwhelming data on the negative consequences of alcohol, tobacco, and illegal drugs. This is why ASAM is currently focusing efforts only on addictions to these substances.

On the other hand, psychiatrist Michael Brody, MD, a spokesman for the American Academy of Child and Adolescent Psychiatry, defines addiction with the following criteria:

A person needs more and more of a substance or behavior to keep him or her going.

If the person does not get more of the substance or behavior, she or he becomes miserable and irritable.

An addiction can apply to anything from caffeine to the Internet, says Brody.

Regardless of the debate on the terminology, the fact is that compulsive use of things such as the Internet exists and causes real problems, says Greenfield. He also notes that people who abuse the Internet show the same characteristics as those who abuse drugs or alcohol. These warning signs of addictioninclude:

Greater sense of isolation

Diminished social interaction

Reduced attention to personal hygiene

More legal difficulties

Change in eating and sleeping patterns

Increased irritability

Reluctance to change the compulsive behavior

The Root of Addiction

At first, Rachel (not her real name) didn't think anything was wrong with using sex as weapon to get her way in relationships with men -- even when her plan to turn an unfaithful boyfriend's head meant sacrificing grocery money for the latest line of lingerie and toys.

"I did feel an adrenaline rush when ... I could turn his head instead of him cheating with somebody else," says the 47 year-old school counselor. "It felt like a hit -- like I downed shots of liquor -- when my plan worked."

Her decision to stick with the same unfaithful boyfriend magnified the problem. She would habitually comb through his wallet, address book, and receipts, recording the information so that she would know where to look for him on nights he was missing.

Rachel describes regularly searching bars and his friends' apartments in her pajamas, pounding on people's doors, harassing them on the phone, sometimes wearing dark clothes in order to better stalk houses, and having car chases with her boyfriend once she found him.

Her all-night pursuits and seduction schemes lasted nearly two decades before she was diagnosed with a sex addiction. By that time, she had contracted a number of sexually transmitted diseases from her boyfriend to the point that she may be infertile. She alienated family and friends and became extremely depressed and suicidal.

How could things get so bad? Experts say people like Rachel have a medical illness; much like high blood pressure or diabetes is an illness.

In addiction, something is wrong with the brain, explains Brody. Parts of the brain may become stimulated with some behaviors, he says, while at the same time, people's habits may change pathways in the brain.

It's the classic chicken-and-the-egg question. Which came first: the brain chemistry making people susceptible to addiction, or the compulsive behavior changing brain structures? Scientists are still trying to figure out the answer.

Nonetheless, biology may play a role in making people feel good, encouraging the emotionally vulnerable to act out in order to self-medicate, says Angie Moore, a licensed counselor in the treatment of alcohol, drug, and gambling addiction, and a spokeswoman for the Illinois Institute for Addiction Recovery.

Because there is an explosion of dopamine (a neurochemical that make people feel good) with an enjoyable experience, "the depressed or anxious may feel relief as a result of engaging in an addicting behavior," says Moore. The problem with addicts is that there is some dysfunction in the part of the brain responsible for controlling behavior.

Biology doesn't work alone, however. Specialists say environmental factors also have a big role in promoting addictive behavior. People may follow their parents' or peers' examples. Plus, the availability of certain substances or the ease in which a person can act out and get away with it may also encourage addiction.

In Rachel's case, she eventually realized that sex became a weapon for her, not only because it gave her a high, but it also reinforced the idea learned from her family life -- that there were no boundaries with sex. As a child, she was molested by her father.

Treating Addiction

Treatment facilities abound for addictions, but not all of them deal with all kinds of compulsive behavior. There are places, though, that specialize in only one type of habit, like sex or Internet addiction.

The Illinois Institute for Addiction Recovery treats all kinds of abuse as officials there believe that individuals susceptible to one addiction are vulnerable to other compulsions. Patients there learn that freedom from all abusive behavior requires a lifelong commitment, including attendance of individual or group therapy, or 12-step groups.

In his practice, Greenfield also uses the philosophy that all addictions probably have the same neurochemical issue at hand, and recovery not only involves breaking the pattern of abuse, but also maintaining consciousness of behavior for life.

"It's very easy in a moment of weakness to resort back to a previous pattern that is well established," he says, likening the pathways of addiction to a riverbed. "When it rains, it always goes back to that original riverbed. It's a well-rehearsed path."

The bottom line, though, is that recovery is possible. The Illinois Institute reports that up to 80% of patients remain free of addictions at least six months after their primary treatment.

Greenfield says he's treated dozens of Internet addicts who have been able to achieve reasonable patterns of Web use.

As for Rachel, after realizing she had a problem, she began going to intense individual and group therapy and attending meetings with the Sex and Love Addicts Anonymous (SLAA), 12-step program modeled after Alcoholics Anonymous.

Now, a dozen years later, she reports having better relationships with her family and friends and having enough energy to have completed a PhD in education. She is also looking forward to her next love connection after being able to have two healthy relationships since her unfaithful boyfriend.

The road to recovery hasn't been easy, but now that she feels stronger, Rachel says she believes her future is bright. "My worst day sober is still better than my best day acting out," she says.